Differential Diagnosis for Incontinence of Semen

• Single most likely diagnosis
  • Retrograde ejaculation: This condition occurs when semen enters the bladder instead of exiting through the penis during ejaculation, often due to issues like diabetes, surgery, or certain medications. It's a common cause of incontinence of semen.
• Other Likely diagnoses
  • Premature ejaculation: Although not exactly incontinence, premature ejaculation can lead to a sensation of loss of control over ejaculation, which might be perceived as incontinence.
  • Erectile dysfunction with leakage: In some cases, erectile dysfunction can lead to incomplete erections, and semen might leak out without a full erection or ejaculation.
  • Prostatitis or prostate issues: Inflammation or infection of the prostate can cause discomfort and lead to involuntary leakage of semen.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular cancer: Although rare, testicular cancer can cause a variety of symptoms including changes in ejaculation or semen. Early detection is crucial.
  • Spinal cord injury or disease: Conditions affecting the spinal cord can disrupt normal sexual function, including ejaculation. Missing a spinal cord issue could lead to further neurological damage.
  • Neurological disorders (e.g., multiple sclerosis, Parkinson's disease): These conditions can affect bladder and sexual function, leading to symptoms like incontinence of semen.
• Rare diagnoses
  • Ejaculatory duct obstruction: A blockage in the ejaculatory ducts can prevent semen from exiting properly, potentially leading to incontinence.
  • Cowper's gland issues: Problems with the Cowper's glands, which produce pre-ejaculate fluid, can lead to abnormal ejaculation patterns.
  • Urethral stricture or injury: Damage to the urethra can cause a range of urinary and sexual symptoms, including incontinence of semen.